title: Motion compensated digital tomosynthesis.
abstract: OBJECTIVE
  Digital tomosynthesis (DTS) is a limited angle image reconstruction method for cone beam projections that offers patient surveillance capabilities during VMAT based SBRT delivery. Motion compensation (MC) has the potential to mitigate motion artifacts caused by respiratory motion, such as blur. The purpose of this feasibility study was therefore to develop and evaluate motion-compensated DTS (MC-DTS).
  
  
  METHODS
  MC-DTS images were reconstructed by back projection of X-ray projection images acquired over 30° arcs. Back projection lines were deformed according to an a priori motion model derived from the 4D planning CT. MC-DTS was evaluated on a respiratory motion phantom and 3 lung cancer patients. Respiratory artifact reduction was assessed visually and quantified by fitting a cumulative Gaussian function to profiles along the background-GTV transition in the CC direction.
  
  
  RESULTS
  MC reconstruction was fast enough to keep up with image acquisition and considerably reduced motion blur visually. Quantitatively, MC reduced the background-GTV transition distance by 49%.
  
  
  CONCLUSIONS
  Motion compensation considerably improved the image quality of DTS images of lung cancer patients, giving an opportunity for more accurate DTS guidance and intra-fraction monitoring concurrent with VMAT delivery.
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: van der Reijden
authors.forename: Marcel
authors.initials: M
authors.lastname: van Herk
authors.forename: Jan-Jakob
authors.initials: JJ
authors.lastname: Sonke
mesh_terms: D016477:Artifacts; D056973:Four-Dimensional Computed Tomography / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D009038:Motion; D019047:Phantoms, Imaging; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*
keywords: Digital tomosynthesis; Image guided radiotherapy; Intrafractional motion; Motion compensation; Respiratory motion